scholarly journals Abdominal wall augmentation techniques used in complex postincisional hernias repair

2019 ◽  
Vol 2 (1) ◽  
pp. 41-49
Author(s):  
Roxana Florina Ristea ◽  
Daniel Ion ◽  
Alexandra Bolocan ◽  
Radu Palade
Keyword(s):  
Abdominal Wall ◽  
Tumor Resection ◽  
Economic Problem ◽  
Surgical Approaches ◽  
Suture Repair ◽  
Long Term Follow Up ◽  
Augmentation Techniques ◽  
Recurrent Defects ◽  
Functional Consequences ◽  
The Aesthetic

One of the most common unwanted consequence of abdominal surgery is the development of an incisional hernia. It occurs in up to 20% or more of laparotomies [1], [2]. Complex defects of the abdominal wall may also be caused by infection, trauma or tumor resection [3]. Complex and recurrent defects of the abdominal wall represents a challenging surgical and a socio-economic problem due to the time and material expenses [2]. Besides the aesthetic disfigurement those defects may also lead to functional consequences with poor protection of the intra-abdominal viscera [4]. Various surgical approaches can be used in hernia repair in an open fashion or minimally invasive  laparoscopic or robotic techniques. Mesh herniorrhaphy was demonstrated to be superior to suture repair alone, with a recurrence rate of 32% compared with 63% in long-term follow-up, in spite of the advances made in mesh materials, surgical technique and perioperative care [1]. Regardless the approach, the tension-free repair remain the basis of modern herniology [5].

Left Pan-Hippocampal Low Grade Glioma—2-Stage Transsylvian Transventricular and Paramedian Supracerebellar Transtentorial Approaches: 2-Dimensional Operative Video

2018 ◽  
Vol 16 (3) ◽  
pp. E82-E82
Author(s):  
Juan C Fernandez-Miranda
Keyword(s):  
Tumor Resection ◽  
Spatial Relationship ◽  
Low Grade Glioma ◽  
Parahippocampal Gyrus ◽  
Surgical Approaches ◽  
Low Grade ◽  
Fiber Tractography ◽  
High Definition ◽  
Posterior Portion ◽  
Fiber Tracts

Abstract The surgical goal for low-grade gliomas (LGGs) is to maximize resection while minimizing morbidity. Pan-hippocampal LGGs extend from the hippocampal head to the hippocampal tail, and involve the parahippocampal gyrus and uncus. Given their anteroposterior extension, they cannot be completely removed with 1 single approach, requiring a 2-stage front-to-back operation.  In this video, we present the case of a 52-yr-old man with new onset of generalized seizures and a dominant-side, nonenhancing, pan-hippocampal infiltrative lesion compatible with a low-grade glioma. Preoperative high-definition fiber tractography (HDFT) showed the spatial relationship of the tumor with surrounding fiber tracts, such as the arcuate, inferior fronto-occipital, and middle longitudinal fascicles, and optic radiations.  Surgical resection was planned in 2 separate stages. The first stage consisted of a transsylvian transinferior insular sulcus approach to the extra- and intraventricular aspects of the uncohippocampal region. The entire anterior and middle portions of the tumor were successfully removed with minimal morbidity, including transient naming difficulties and permanent superior quadrantanopia. Postoperative HDFT showed preservation of all fiber tracts, except for a portion of Meyer's loop and the inferior-most aspect of the inferior fronto-occipital fascicle. The second stage was completed 8 wk later and consisted of a paramedian supracerebellar-transtentorial approach on sitting position. The posterior portion of the tumor was entirely removed to achieve a complete macroscopic tumor resection. The final diagnosis was IDH1-positive LGG.  Pan-hippocampal tumors remain a surgical challenge but accurate knowledge of surgical neuroanatomy and surgical approaches facilitates their safe and effective treatment.  The patient signed an informed consent including the use of photographic and video material for educational or academic purposes.

scholarly journals Positive outcome in a high-grade myxofibrosarcoma: a case report

2018 ◽  
Vol 1 (1) ◽  
pp. 27-30
Author(s):  
Mihaela Olaru ◽  
Cornelia Nitipir
Keyword(s):  
Case Report ◽  
Fibrous Histiocytoma ◽  
Tumor Resection ◽  
Pulmonary Nodules ◽  
Positive Outcome ◽  
Pet Ct ◽  
Longus Muscle ◽  
Long Term Follow Up

AbstractMyxofibrosarcoma or myxoid malignant fibrous histiocytoma is one of the most common sarcomas of the limb. It is usually treated multimodally. Most frequent sites of metastasis are the bone, lung and lymph nodes. The present paper is a case report of a 65-year-old male with myxofibrosarcoma of the fibularis longus muscle, for which he first underwent surgery - tumor resection with appropriate margins. The tumor was staged pT2b cN0 cM0. Postoperative PET-CT revealed metabolically inactive pulmonary nodules. Two months after surgery, he underwent adjuvant radiotherapy, a total dose of 60 Gy and 6 courses of chemotherapy (doxorubicin and ifosfamide). Pulmonary nodules have been stationary on all subsequent imagistic studies. He is free of recurrence on long-term follow-up.

scholarly journals P138 PREPERITONEAL ENDOSCOPIC GROIN HERNIA SURGERY - REASSESSMENT OF TOPOGRAPHIC ANATOMY AS A BASIS FOR STANDARDIZED DESCRIPTION OF SURGICAL STEPS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Marvin Heimke ◽  
Tilmann Heinze ◽  
Andreas Kuthe ◽  
Thilo Wedel ◽  
Christoph W Strey
Keyword(s):  
Abdominal Wall ◽  
Groin Hernia ◽  
Histological Study ◽  
Learning Curves ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Hernia Surgery ◽  
Mesh Placement ◽  
Topographic Anatomy ◽  
Total Extraperitoneal

Abstract Aim Fascial groin anatomy remains a conundrum. In particular, a clear anatomical allocation of the correct extraperitoneal dissection planes and spaces in total extraperitoneal endoscopic hernia surgery (TEP) has not yet agreed upon. The differing anatomical concepts are reflected by the variability of surgical approaches, the considerably long learning curves and subsequent complications. Thus, the aim of this study was to reassess the topographic anatomy of the groin region providing a basis to standardize the surgical steps of TEP according to clearly defined anatomical landmarks. Material and Methods Video analysis of intraoperative surgical anatomy of groin hernia patients was correlated with the findings retrieved by macroscopic anatomical studies. The groin region of formalin fixed body donors was subjected to a stepwise dissection exposing the fascial system of the abdominal wall layer-by-layer and via different angles. Selected areas of interest were processed for histological study. Surgically relevant anatomical landmarks were defined and termed according to the most appropriate anatomical nomenclature. Results The essential surgical dissection steps during TEP could be related to specific anatomical landmarks extending within the extraperitoneal space of the ventral and dorsolateral abdominal wall. The definition of fascial structures and interfaces and the identification of structures at risk allowed the identification of correct dissection planes for mesh placement. Conclusions Our study helps to clarify the definition and nomenclature of anatomical key structures required for a standardized description of TEP in a simplified model. The data may contribute to reduce complications and improve surgical teaching and training.

scholarly journals Influence of neodymium laser radiation on the frequency of recurrence and continued growth of extramedullary tumors

2021 ◽  
Vol 18 (3) ◽  
pp. 77-85
Author(s):  
I. A. Eliseenko ◽  
S. G. Struts ◽  
V. V. Stupak
Keyword(s):  
Laser Radiation ◽  
Tumor Resection ◽  
Relative Number ◽  
Neodymium Laser ◽  
Long Term Results ◽  
Primary Tumors ◽  
Classical Technique ◽  
Long Term Follow Up ◽  
Microsurgical Techniques

Objective. To assess the effect of neodymium laser radiation on the recurrence rate and continued growth of primary extramedullary tumors on the basis of clinical data obtained in the long-term follow-up period in operated patients with extramedullary tumors.Material and Methods. The long-term results of surgical treatment of two groups of patients (n = 412) with primary extramedullary tumors operated on from 1998 to 2014 were studied and systematized. Patients of comparison group (n = 277; 67.2 %) underwent removal of tumors using standard microsurgical techniques, and the neoplasms in patients of the study group (n = 135; 32.8 %) were removed with additionally used neodymium (Nd:YAG) laser.Results. The use of the developed laser technologies for the resection of extramedullary intracanal primary tumors made it possible to reliably reduce the relative number of recurrence and continued growth from 11.1 % to 1.2% compared with patients treated with standard surgery methods. The proportion of recurrences was 3.5 %, all of them were detected only in the group with the classical technique of tumor resection (p <0.01).Conclusion. The use of a neodymium laser as an additional technology to the classical microsurgical resection of extramedullary tumors is effective for the prevention of their recurrence and continued growth.

Vascular Anomalies

2019 ◽  
pp. 241-260
Author(s):  
Lara Wine Lee ◽  
Cameron C. Trenor
Keyword(s):  
Functional Impairment ◽  
Vascular Tissue ◽  
Vascular Malformations ◽  
Diagnostic Procedures ◽  
Vascular Anomalies ◽  
Surgical Approaches ◽  
Vascular Tumors ◽  
Vascular Abnormalities ◽  
The Aesthetic ◽  
Excessive Proliferation

The chapter provides a description of the main anomalies characterized by excessive proliferation of the vascular tissue and the major syndromes associated with them. The predominant types of vascular anomalies are vascular tumors and vascular malformations. Vascular tumors are further subdivided in benign, locally aggressive, and malignant, according to the clinical course of the lesions, while vascular abnormalities are classified as simple (capillary, lymphatic, venous, arteriovenous, and arteriovenous fistula) or combined. For each subgroup of vascular anomalies, clinical presentation and diagnostic procedures are discussed, as well as pathogenic mechanisms and potential comorbidities. The management of vascular anomalies may be oriented to treat the aesthetic discomfort as well as the functional impairment and may involve both pharmaceutical and surgical approaches.

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